This textbook describes PTM intimately. minimum heritage info is supplied with the point of interest on describing the medical methods for undertaking PTM. The guide comprises 25 separate appendices to facilitate the medical implementation of PTM with the fitting flowcharts, procedural courses, questionnaires, sufferer handouts, and varieties. A CD and DVD are incorporated.

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Clinical Implementation of PTM By collecting formative data during the implementation of PTM in the Tampa VA Audiology Clinic, we learned that preplanning for some of the activities could improve the implementation process. For example, prior to starting the program, administrators should know that (a) the PTM audiologists will require release time to complete the Webcourse; (b) the audiologists will be working with psychologists, which will require preplanning with the psychology section of the hospital; (c) patients being seen for tinnitus will need hearing evaluations and may need ear-level devices; and (d) the PTM protocol necessitates access by audiologists to a meeting room for the Level 3 workshops.

We also recommend holding regular calls or meetings with audiologists who are beginning to use the protocol to address barriers that may arise as they put PTM into practice. Valuable information can be identified and acted on to improve fidelity to protocol. Patients in this pilot study were all veterans at the Tampa VA hospital who complained of bothersome tinnitus. As all of the patients in the PTM cohort were offered tinnitus services beyond Level 2 Audiologic Evaluation, it is clear that the majority of these patients either chose not to receive higherlevel services or it was too difficult for them to attend the additional visits that were required to participate in the Level 3 workshops.

However, the condition is “clinically significant” for only about 20% of those who experience tinnitus (A. Davis & Refaie, 2000; P. J. Jastreboff & Hazell, 1998). Tinnitus that is “clinically significant” indicates that the tinnitus causes functional impairment to such a degree that clinical intervention is warranted. Although difficult to define, some criterion level of functional impairment would categorize an individual as requiring clinical intervention. Determining this criterion level must be based on the person’s perception of the need for intervention.